#Engage4Health at HIMSS: Evaluate When #HITWorks vs When HIT Just Happens

by Mandi Bishop

As a veteran HIMSS Annual Conference attendee and healthcare IT industry professional/critic, I’m always atwitter come spring.

  • Who’s keynoting?
  • Who’s throwing what fabulous party?
  • Who’s announcing a merger?
  • Who’s showcasing an innovative new solution to a chronic industry pain point – and
  • Who’s soothing pain we didn’t realize we had?

It’s a heady time of year. It can be easy to get lost in the hype cycle that precedes and permeates the event, to let the glitz and glitter of the multi-million dollar booths overcome your critical thinking processes with free gourmet coffee drinks.

I believe we owe it to ourselves, as engaged consumers who are also the purveyors of this industry’s wares, to evaluate the “man behind the curtain” at every opportunity. Is the showcase solving actual problems with real-world solutions that can be applied appropriately, and at scale? Or is it snake oil?

Don’t be fooled by the virtual reality that is on display; find the truth behind the booth.

The following is my best effort to cling to signal through the noise, using a few of my favorite official HIMSS hashtags to align conference themes with recent events concerning “engagement” – and apply critical thinking, before the diversion of the booth swag can take hold.

Patient/Member/Consumer Engagement at HIMSS - History

“Engagement” has been forefront at the HIMSS Annual Conference, and in the healthcare community, for several years now, gaining steam quickly when Stage 2 of the Meaningful Use of EHR program mandated sharing clinical encounter data with patients. The definition of engagement, the semantics declaring the person/community/entity being engaged, as well as the success of these engagement measures, has been hotly contended. The Connected Patient Pavilion space and speakers at HIMSS14 set the stage for “patients-included” conversation about the design and use of healthcare IT.

At HIMSS15, one of the hottest topics of discussion was the impact to engagement efforts due to breaking news that the Centers for Medicare and Medicaid Services (CMS) was reducing the View/Download/Transmit measure requirement from 5 percent of the patients to one single patient.

Vocal and influential patient advocates, such as Casey Quinlan, Regina Holliday, and Dave deBronkhart – as well as former Office of the National Coordinator (ONC) National Coordinator Dr. Farzad Mostashari - lambasted the move, and the hashtag #NoMUWithoutMe became a trending topic (as well as a frequently seen profile avatar). In July 2015, the National Partnership for Women & Families aligned with these powerful advocates and groups and launched the Get My Health Data campaign, and the call to action on #DataIndependenceDay resounded across social media platforms.

So, have we made any progress?

Recent Engagement News: HIPAA Privacy Rule Mandating Medical Records Access

The groundwork for engagement improvement is being laid, and fundamental misconceptions about privacy protections prohibiting data-sharing are beginning to fall by the wayside. Long (mis)used as a barrier to patient and caregiver communication about the information in medical records, the Health Insurance Portability and Accountability Act (HIPAA) is undergoing changes and clarification efforts to ensure that the privacy rules comprising the most-discussed (and most frequently misunderstood) components do not continue to be a lame excuse for data-blocking.

According to the New York Times, January 2016 HIPAA Privacy Rule guidelines issued by the US Department of Health and Human Services (HHS) require doctors and hospitals to release records to patients upon request “in most cases,” without the patient having to provide a supporting reason, with a 30-day maximum delivery time, and without the ability for the covered entity to deny access due to concerns about the patient’s ability to “understand” and not be upset by the information.

Simple enough, right? Let’s break it down.

Patients can request their complete medical records, which are defined as any personal health information (PHI) that is used to make decisions about an individual’s care - including unstructured data such as clinical notes - from ANY covered entity:

  • healthcare providers,
  • payers,
  • third party administrators,
  • care and disease management program fulfillment services, even
  • claims clearinghouses,

...should they like.

Onerous request and identity verification methods are prohibited: specifically, the covered entity cannot require a requestor to show up in-person to request that the records be mailed to their home, and multiple access request/access delivery method options are encouraged.

Covered entities must respond with the records requested within 30 days with the records in the requested format, if at all possible; one 30-day extension, and only one, can be granted as long as it is preceded by an explanation from the covered entity.

This is a big deal.

HHS just opened the door for all patients to receive their complete medical chart information, without censure, provided that information is not contained mental health professional session notes and does not jeopardize the individuals named in the PHI (as may be the case for inmates and guards, for example).

And HHS is requiring that the covered entities supply the information in the manner requested by the individual, provided the information is stored in a suitable format and can be transmitted with an agreed-upon degree of security. HHS explicitly declares unsecure email a suitable method of transport, as long as the requestor understands the risk and consents to the lack of security while the information is in transit.

In short:

HIPAA now says your provider is now allowed to email you an electronic copy of your complete medical record, within 30 days of your request, assuming you authorize the risk. If your provider tells you they are prohibited from emailing you information due to HIPAA, you can cite otherwise, and file an official complaint if they do not comply.

Read the rest of Mandi Bishop’s Industry Perspective tomorrow on the HIMSS16 News Feed.